Tumor oxygenation imaging biomarkers using dynamic susceptibility contrast imaging for prediction of IDH mutation status in adult-type diffuse gliomas.

in European radiology by Yae Won Park, Kyunghwa Han, Geon Jang, Minjee Cho, Si Been Kim, Hyeonjin Kim, Na-Young Shin, Jong Hee Chang, Se Hoon Kim, Seung-Koo Lee, Sung Soo Ahn

TLDR

  • The study found that imaging parameters related to tumor oxygenation are associated with IDH mutation status in adult-type diffuse gliomas.
  • Lower CMRO and OEF values predicted IDH mutation, and these findings may aid in noninvasive prediction of IDH mutation.

Abstract

To evaluate the role of tumor oxygenation imaging parameters in predicting the isocitrate dehydrogenase (IDH) mutation status in adult-type diffuse gliomas. This retrospective study included 296 patients with adult-type diffuse glioma (237 IDH-wildtype, 59 IDH-mutant). The normalized cerebral blood volume (nCBV), cerebral metabolic rate of oxygen values (CMRO), capillary transit time heterogeneity, and oxygen extraction fraction (OEF) values from dynamic susceptibility contrast (DSC) imaging and ADC values from DWI were obtained from autosegmented tumor masks. Logistic analyses were performed in entire patients and in a subgroup of 46 patients (15.6%) without CE tumors. In entire patients, 10th percentile of CMRO(odds ratio [OR] = 0.64, p < 0.001) and 10th percentile of OEF (OR = 0.32, p < 0.001) independently predicted IDH mutation, along with age, frontal location, presence of CE tumor, and 90th percentile of nCBV, with an area under the curve (AUC) of 0.92 (95% confidence interval [CI] 0.88-0.95). In the subgroup of patients without CE tumors, 10th percentile of CMRO(OR = 0.58, p = 0.044) was an independent predictor for IDH mutation, along with age, and 10th percentile of ADC with an AUC of 0.94 (95% CI 0.83-0.99). Tumor oxygenation parameters, including CMROand OEF, may predict IDH mutation independently of previously known clinical and quantitative imaging data. Lower 10th percentile of CMROand OEF predicts IDH mutation in entire tumors, while lower 10th percentile of CMROpredicts IDH mutation in patients without CE tumors. Question The role of tumor oxygenation imaging parameters for predicting the IDH mutation status in adult-type diffuse gliomas is unknown. Findings Lower cerebral metabolic rate of oxygen values (CMRO) and oxygen extraction fraction (OEF) predicted IDH mutation in entire tumors, while lower CMROpredicted IDH mutation in patients without enhancing tumors. Clinical relevance Tumor oxygenation parameters derived from dynamic susceptibility contrast (DSC) perfusion imaging may assist noninvasive prediction of IDH mutation in adult-type diffuse gliomas.

Overview

  • The study aimed to investigate the role of tumor oxygenation imaging parameters in predicting the isocitrate dehydrogenase (IDH) mutation status in adult-type diffuse gliomas.
  • The study included 296 patients with adult-type diffuse glioma, with 237 IDH-wildtype and 59 IDH-mutant.
  • The main objective of the study was to identify the tumor oxygenation parameters that independently predict IDH mutation status, while controlling for clinical and quantitative imaging data.

Comparative Analysis & Findings

  • In the entire patient group, 10th percentile of CMRO and OEF values independently predicted IDH mutation, along with age, frontal location, presence of CE tumor, and 90th percentile of nCBV.
  • In the subgroup of patients without CE tumors, 10th percentile of CMRO was an independent predictor for IDH mutation, along with age, and 10th percentile of ADC.
  • The area under the curve (AUC) was 0.92 for the entire patient group and 0.94 for the subgroup of patients without CE tumors.

Implications and Future Directions

  • The study suggests that tumor oxygenation parameters derived from dynamic susceptibility contrast (DSC) perfusion imaging may assist noninvasive prediction of IDH mutation in adult-type diffuse gliomas.
  • Future studies may explore the use of these imaging parameters in combination with other biomarkers to improve diagnostic accuracy.
  • Further investigation is needed to validate these findings in a larger and more diverse patient population.
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